Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Nov 2013
Multicenter StudyDoes uncontrolled cardiac death for organ donation raise ethical questions? An opinion survey.
Organ donation after uncontrolled cardiac death raises complex ethical issues. We conducted a survey in a large hospital staff population, including caregivers and administrators, to determine their ethical viewpoints regarding organ donation after uncontrolled cardiac death. ⋯ Only 46% of hospital-based caregivers and managers appear to accept easily the legitimacy of organ donation after cardiac death. A significant number of respondents especially intensivists, expressed concerns over the dilemma between the interests of the individual and those of society. These results underline the need to better inform both healthcare professionals and the general population to help to the development of such procedure.
-
Acta Anaesthesiol Scand · Nov 2013
Randomized Controlled Trial Comparative StudyAddition of lidocaine to bupivacaine for spinal anaesthesia compared with bupivacaine spinal anaesthesia and local infiltration anaesthesia.
Two spinal anaesthesia techniques were compared with local infiltration anaesthesia (LIA) to test the hypothesis that the addition of lidocaine to bupivacaine would decrease the spinal block's duration and provide shorter recovery to discharge. ⋯ Addition of lidocaine to bupivacaine reduced the duration of the spinal block and was associated with shorter recovery times. However, LIA provided the fastest recovery to discharge after outpatient inguinal herniorrhaphy.
-
Acta Anaesthesiol Scand · Nov 2013
Impact of national guidelines on reporting anaphylaxis during anaesthesia - an outcome audit.
Anaphylaxis during anaesthesia is a rare and potentially fatal event. Adequate reporting and investigation of anaphylaxis associated with anaesthesia results in improved patient safety and outcomes. Guidelines from the Association of Anaesthetists of Great Britain and Ireland (AAGBI) designed to improve this process were first issued in 1990 and updated in 1995, 2003 and 2008. In a setting where no formal guideline was previously in place, we compared the reporting and investigation of anaphylaxis in a large hospital before and after the introduction of the 2008 guideline. ⋯ Implementation of the AAGBI guidelines locally in a large hospital in 2008 resulted in an improved awareness of the importance of reporting and investigation of suspected anaphylaxis under anaesthesia. This tool was implemented coincidentally with the change in hospital antibiotic prophylaxis and enabled the cases detected to be accurately recorded and investigated. This led to a change in the hospital antibiotic policy for surgical prophylaxis. Implementation of structured guidance from a national anaesthesia organisation enhances recognition of the clinical features of anaphylaxis, increases number and completeness of referrals and more thorough immunological investigation, leading to improved patient safety during anaesthesia.
-
Acta Anaesthesiol Scand · Nov 2013
Randomized Controlled TrialEffects of adrenaline on rhythm transitions in out-of-hospital cardiac arrest.
We wanted to study the effects of intravenous (i.v.) adrenaline (epinephrine) on rhythm transitions during cardiac arrest with initial or secondary ventricular fibrillation/tachycardia (VF/VT). ⋯ Patients who received adrenaline had more rhythm transitions from ROSC and non-shockable rhythms to VF/VT.
-
Acta Anaesthesiol Scand · Nov 2013
Do pre-hospital anaesthesiologists reliably predict mortality using the NACA severity score? A retrospective cohort study.
The National Advisory Committee on Aeronautics' (NACA) severity score is widely used in pre-hospital emergency medicine to grade the severity of illness or trauma in patient groups but is scarcely validated. The aim of this study was to assess the score's ability to predict mortality and need for advanced in-hospital interventions in a cohort from one anaesthesiologist-manned helicopter service in Northern Norway. ⋯ The NACA score had good discrimination for predicting mortality and need for respiratory therapy. It is thus useful as a tool to measure overall severity of the patient population in this kind of emergency medicine system.